<?=form_open(uri_string());?>
<table class="form">
    <tr>
        <td class="w150 required label">Tỉnh thành</td>
        <td><input type="text" name="town_name" id="town_name" style="width: 400px;" value=""></td>
    </tr>
    <tr>
        <td class="w150 required label">Thứ tự</td>
        <td><input type="text" name="sort_no" id="sort_no" style="width: 400px;" value=""></td>
    </tr>
    <tr>
        <td class="label">Trạng thái</td>
        <td><input type="checkbox" name="bl_active" id="bl_active"  value="1" checked  onclick="setCheckboxValue(this);"></td>
    </tr>
    <tr>
        <td class="label"></td>
        <td class="footer"><input type="submit" name="bt_submit" class="themmoi"></td>
    </tr>
</table>
<?=form_close();?>
